Coexistence of gynecological pathology with endometriosis and adenomyosis

Both endometriosis and adenomyosis can impact quality of life. Endometriosis is a chronic, benign, condition characterized by the growth of endometrium outside the uterus, which affects ~10% of women from menarche to menopause, globally. Adenomyosis is a benign gynecological condition, which is defined as the infiltration of ectopic endometrial tissue within the underlying myometrium. It is often diagnosed in perimenopausal women aged 40-50 years, with a prevalence that varies widely (ranging from 1-70%). The aim of the present study was to determine the histological coexistence of gynecological pathology in women with endometriosis, adenomyosis and those with both. In the present retrospective study, data retrieved from the medical records of women that underwent abdominal hysterectomy with bilateral or unilateral salpingo-oophorectomy at the Department of Obstetrics and Gynecology of Venizeleio General Hospital and the Third Department of Obstetrics and Gynecology of Aristotle University of Thessaloniki (Greece) between 2000-2022 were included. Patients were divided into three groups; group 1 included those with endometriosis, group 2 included those with adenomyosis and group 3 included those with both endometriosis and adenomyosis. Cases with inadequate medical records and those lacking histological diagnoses were excluded. The total number of patients included in the present study was 1,692 women; group 1 included 495 (29.2%) patients, group 2 included 1,096 (64.8%) patients and group 3 included 101 (6.0%) patients. The results of the present study revealed that the most common pathology was leiomyomas (43.3%), followed by endometrial and cervical polyps (17.6 and 9.8%, respectively). Benign ovarian (12.2%) and paraovarian cysts (13.7%) were also observed. Compared with groups 1 and 2, leiomyomas were significantly more common in group 3 (67.3%). Endometrial cancer was significantly more common in group 2 (9.3%), compared with group 1 (1.6%) and group 3 (4%). The present study suggested that endometriosis, adenomyosis or the concomitant presence of both may coexist with various benign and malignant gynecological diseases.